AB0325 DEVELOPMENT OF A MOBILE APP FOR DISEASE-SPECIFIC COGNITIVE BEHAVIOR THERAPY MANAGEMENT IN INDIVIDUALS WITH RHEUMATOID ARTHRITIS
Authors: B. M. Elnady, S. Abd-Elmaksoud, O. El Miedany, Y. El Miedany
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> EULAR has recently highlighted the vital role of digital health in standard practice and the possibility to enhance the patient's quality of life. Cognitive Behavior Therapy (CBT) plays an important role in improving clinical outcomes in inflammatory arthritis patients. The aim of CBT is to boost patients' self-efficacy for pain management, or their confidence in their ability to control their pain, and lessen the interference that pain causes in their everyday lives. CBT does this by educating patients on how to develop more efficient coping mechanisms to deal with everyday pain sensations and enhance functionality and quality of life. So far, no comprehensive mobile app has been developed to facilitate the collaboration between patients and their CBT therapist, especially with those having monetary and physical constraints related to their disease. <h3>Objectives</h3> 1-To provide basic data on system requirement specifications for a mobile app to provide constructed CBT program for RA patients 2. Identify the target audience, characteristics of the app, and correlations between the system requirements and the established CBT. <h3>Methods</h3> To identify the major themes recognised as the main pillars for app development and inform the app developer/machine learning engineer, a participatory action research design was implemented. Qualitative data were collected using multiple methods in four workshops. Participants were 2 Rheumatologists, 1 rheumatology nurse specialist, 1 Psychiatrist4 rheumatoid arthritis patient, and an App developer. A taxonomy was used to determine the degree of correlation between the system requirements and established cognitive behavioral therapy techniques. <h3>Results</h3> The app targets the optimization of patient-reported outcomes and quality of life to provide a non-medical management approach via modifying Disease-specific dysfunctional beliefs and behaviors using cognitive and/or behavioral exercises in a structured manner. The major themes identified were: 1. collect self-completed patient-reported outcomes (disease functional ability, quality of life, motivation), 2. Collect information on patient demographics, comorbidity(ies), disease activity status (self-reported disease activity score), plus past and current medications, 3. Identify the individual patient's target to be achieved, 4. Develop a patient profile that focuses on the patient's perpetuating factors, 5. construction of a personalized, evidence-based disease management program based on recommendations from medical guidelines, medical standards, and state-of-the-art clinical research; 6. implementation of a personalized CBT program for Effective Coping, Life Goals, Pain Management, Emotional Responses, Managing Change, Self-Esteem, Relationships 7. a calendar feature for goal setting, planning, and recording of physical activity performance and progress, 8. a small community feature for positive feedback, support from peers and support the patient in coping with stress, sadness, depression, pain, fatigue, and further disease-related symptoms, 9. Implementation of relaxation exercises, 10. adapt a reward system to motivate end users for using the app,11. to help the patients learn ways to cope with increased resilience to disease-related episodes.12. Format the app interface. <h3>Conclusion</h3> These findings highlight the potential of implementing digital CBT to encourage RA patients to be able to cope with their disease, change wrong beliefs, allow them to retain jobs, socialize normally, and engage with healthcare professionals. The results of this work suggest that using an app-based personalized disease management program may reflect significantly on several measures of patient-reported outcomes and disease quality of life in RA considering alleviating conventional physical CBT barriers. Future feasibility testing in a prospective study will firmly establish the reliability, efficacy, and cost-effectiveness of such an app intervention for this cohort of RA patients. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.